The field of trauma treatment is rapidly growing, which means that as a trauma-informed strength coach, I spend a lot of time studying different clinical approaches. And as I do, I witness countless yoga teachers, therapists, somatic therapists, massage therapists, and physical therapists telling the stressed out to take a nice deep breath to get grounded. To this I say: STOP! Please do not insist folks take a deep breath.
On the surface, it makes a lot of sense to tell people to take a deep breath. We commonly think of deep breathing as a way to slow down time, our breath, and ultimately our autonomic nervous system. But guess what — lots of people with chronic stress, post-traumatic stress disorder, or complex post-traumatic stress disorder, will find this act at best, damn near impossible, and at worst, triggering.
Constriction in Our Breathing Muscles
If you live with chronic stress or trauma, there is a good chance that you experience constriction in your primary breathing muscle — the diaphragm.
The diaphragm is a muscle beneath your ribcage that contracts and flattens out to fill your lungs with air. As you exhale, it relaxes and expands upward. When we are breathing at rest in a parasympathetic state, it should handle most of the work.
Working in conjunction with the diaphragm is a whole set of secondary breathing muscles — your intercostals, scalenes, sternocleidomastoids, pecs minor, and abs.
These muscles are of your neck, chest, and belly. And theoretically when you are at rest, they are too. Even when you are working hard in a sympathetic state, they are only handling some of the load. That said, if you live with chronic stress or trauma these muscles are often overused, and your diaphragm does almost none of the work.
Although I had experienced this in my own body, my teacher, Jane Clapp, was the first person I heard speak to this phenomenon. During her Movement for Trauma program, she spoke to the potentially triggering nature of working with the breath and the importance of breathing through the nose. This would go on to inform a lot of what I do with myself and others.
Imagine you are hiking and you see a bear or some other predator you find threatening. Sense into your body. What does it feel like? What are your muscles doing? It is likely your whole trunk is constricted. This is a life-or-death situation, and your limbic system has taken the reins and is going to do its damnedest to save you with some defensive mobilization or immobilization.
Now I am going to ask you to imagine that you are running late for a very important meeting, and you are stuck in traffic or on a stopped subway train without cell service. You are going to miss something very important and have no way to let the others know. Sense into your body. What is your breathing like, and where are you breathing from? Is any air making it into your belly? Probably not. Your whole trunk is constricted even though this is not a life-and-death situation — it is just very stressful.
In both cases — actual life or death, and perceived to be life or death — you braced. And even when that bear runs off, and that train starts to move again, your diaphragm will probably still be constricted with the lingering stress. Many of us don’t realize that we have not relaxed our diaphragms and that we are always bracing our primary breathing muscle to some extent.
I work as a beginning strength coach with the general population in New York City, and I can tell you that for the most part, New Yorkers are a bunch of chest-breathers hustling and living in a very stimulating environment. It is common for people living with trauma, or simply with a lot of stress, to be stuck in a defensive state — fight or flight. Their trunks are always bracing just a little, and that diaphragm rarely gets the chance to move.
What happens to muscles that have not been moved? That’s right — they get stiff and eventually weak. It does not feel good when you become keenly aware that your muscles are stiff and weak. Telling a constricted person to take a deep breath invites them to realize just how tight everything is inside. For some people that may be okay, but for others — people like me — it can feel terrifying. It can feel claustrophobic, suffocating, and absolutely triggering. Deep breaths are a goal for folks like us — not the starting place.
Alternatives to Telling People to Take a Deep Breath
The good news is that there are countless alternatives to get grounded, present, and mindful of the body. The following are a few techniques you can use rather than going straight for the breath.
Neutral Places in the Body
Ask your client to tune into the body and find a place that feels neutral. Encourage the client to put the attention there. Neutrality is often found in places like the hands or the seat. People might feel funny that their butt feels good, but it often does. Let them get grounded by feeling into a part of their body that feels supported and easy, rather than going straight for the center.
When I began to incorporate mindfulness meditation into my own treatment, I realized that the only place that felt safe to focus on was my hands. So that is where I started. Only after many months of daily sitting, as well as using other healing modalities, was I able to move to focusing on the breath.
For some folks, turning inward at all is dysregulating. Suddenly becoming aware of your state can be quite jarring at times. For clients who cannot ground by looking for resources inward, I ask them to become situated and present by looking around and naming five blue things, five red things, and five yellow things. It gets people to closely look at their environment and keeps their prefrontal cortex turned on as opposed to triggering an emotionally reactive limbic response.
Sounds Far to Near, Near to Far
If I am encouraging someone to turn inward I will ask the person to first listen for sounds far away — people talking outside, wind, cars — and then closer sounds like water running through the pipes or cooking sounds in the kitchen, and then even sounds from inside of that person’s own body. If I am trying to bring someone’s awareness back outside of the body, I encourage the same process but in reverse — starting nearby and opening up to sounds far away.
If Breath is the Main Driver of Your Practice
And if breath is the main driver of your practice like in yoga or certain mindfulness meditation practices, you can suggest the client follow the breath without manipulation. By being behind the breath (following it), the constriction can feel less stifling than being on top of it (focusing on it). But please keep in mind that for some people, following or focusing on the breath is a goal, not a tool to be employed right in that moment.
Getting the Diaphragm Moving Again
Lastly, if you work with the body you can help your client get the diaphragm moving again when they are ready. In strength sports we use a diaphragmatic breath and valsalva — a forced exhalation — to brace for each lift. Singers, musicians, dancers, and yogis all use the diaphragm extensively. My coach, Jesse Irizarry, taught me how to teach people to brace to lift. I couple his technique with a gentle inhale to be sure the diaphragm moves. This is how I instruct every person I work with to brace:
- Place your hands on your waist like a weightlifting belt so you can feel as you bring air into your belly.
- Breathe in softly and slowly through the nose, until you fill with air. By breathing through the nose we are going to encourage the use of the diaphragm over the secondary breathing muscles. We are also limiting how much air comes in at once, telling the nervous system it is okay to stay relaxed. A sudden gasp for air will signal to the body it is “go time” and activate a sympathetic response. The body will brace again, and this will defeat the purpose of this exercise.
- At this point, many clients realize how hard it is for them to breathe this way. I reassure them that, yes, it is hard and comes with practice — and we are going to practice with every rep. (If clients are worrying that they won’t be able to take a diaphragmatic breath it will limit their ability to do so!)
- We do this exercise a couple of times together, me showing just how big I can get my belly and how even my thumbs on my back move as air fills my back, not just the front. There is often some giggling because it looks so odd for anyone to so publicly expand the stomach. This giggling is good — we are having fun! In general, after about five breaths the client will see progress in getting increased air into the lower abdomen.
Deep Breaths as a Goal
Yes, now after years of diaphragmatic breathing, I can take a deep breath without panicking, simply because I can take a deep breath at all. But it took work. On behalf of the constricted breathers who panic when they notice their constriction, I am going to ask you to not start with the breath when working with trauma. Get creative or use the tools I listed above, but start somewhere safer, or possibly outside of the body completely.